Thousands of the nation’s poorest children under the age of four are being prescribed stimulants like Ritalin and Adderall for ailments they’re too young to even have. A first-ever CDC study estimates that under the Medicaid healthcare program, doctors have given some 10,000 American toddlers a diagnosis of ADHD and treated them with ADHD drugs that have not been shown to be effective or safe in children that young. The news that amphetamine-based drugs like Adderall and the methylphenidate Ritalin are being used to medicate, at a minimum, one out of every 225 toddlers nationwide outraged some medical professionals when it was first announced in May at the Georgia Mental Health Forum.

“It’s absolutely shocking, and it shouldn’t be happening,” Anita Zervigon-Hakes, a children’s consultant to the Carter Center, which sponsored the forum, told the New York Times. “[Doctors] are just feeling around in the dark. We obviously don’t have our act together for little children.”